I really should be studying. And after this and a bite of lunch, I’ll be back at it. But I need to get out of my own head for a bit. My second semester of PA school is nearly done. I have one paper to submit to two classes (it gets judged separately in both classes) and then two exams. One is a comprehensive final. Oh and some dang fool volunteered to help develop the slide deck for the comprehensive final and lead the study session for that final. Perhaps not my smartest move from a time management point of view, but it does go with my goal of trying to help others. At least I hope my classmates get something out of the study sessions.

What’s on my mind right now, besides cramming some last bits of information into my brain, or at least working to remember what I already learned earlier this semester is my overall GPA. I shouldn’t, but I do. Here’s the deal. I’ve probably mentioned we need a 2.7 or better to progress on in the program. Barring some sort of catastrophe, that’s not an issue. I’ll clear that bar. My first semester GPA was 3.3. I had hoped for a 3.7 (or even a 4.0) but it was quickly clear that that wasn’t going to happen. That said, a 3.3 isn’t to bad. It’s a whole point higher than my overall undergrad GPA. And assuming I continue my trends in the remaining tests and paper, I’ll solidly hit that. (note my program only measures ranges in GPA, <2.7, 2.7, 3.0, 3.3, 3.7, 4.0, hence my fixation on those particular numbers.) A 3.0 still isn’t impossible, but I don’t think I’ll do that poorly. But honestly, even if I do, I’m not going to lose too much sleep over it. Our professors continually tell us as long as we’re getting 80s and above, we’ll pass the PANCE and that’s all that matters. So, I’m good in theory.

Ok, I haven’t gotten out of my head obviously, but let me get away from numbers a bit and talk about the actual classes.

Medicine 1 – This is the meat of the semester. 8 out of 25 credits. I’ve generally enjoyed this. This is obviously a huge part of what we’ll do as PAs. I was doing great until my last exam. Basically I fell about two days behind in terms of studying. But that’s on me. I wouldn’t say the class is difficult per se, but there’s a LOT to learn in a small amount of time. The fact that I’m learning something struck home over Thanksgiving break when I was able to correctly diagnosis one of the ER patients as having COPD and in another case, correctly read a blood gas. (note this was practice, I wasn’t actually involved in any patient care).

Physical Diagnosis I – This honestly was the most fun class I think. Here’s where we actually put hands on bodies (in a consensual way of course). 5 credits, so also important. Whereas Medicine I is a lot of theory, this is more practice. Unfortunately in both practicals my brain skipped a beat and I forgot to perform some of the required exams. But I did well enough. I enjoyed this class and am looking to the follow-up next semester.

Pharmacology and Therapeutics II – this is my Achilles Heel. For me, this is my hardest class. I walked out of the first exam convinced I had failed it. Ironically it was my second best grade in the class. This class is hard for me because it’s basically a LOT of rote memorization. Something that honestly at my age I find harder. It is reassuring that one of my mentors, a triple-board certified ED attending (with one certification in toxicology) admits she has to look up pharm stuff all the time. This is one class I’m NOT looking forward to for the Spring. But I’ve already given some thought about how to tackle it a bit differently and hopefully do better. Only 3 credits, but it’s the biggest drag on my GPA.

Behavioral Health – Honestly, one of the easier classes for me. Some of it was simply “common sense” or stuff I had learned over five decades of living. Some of it was stuff that I honestly had learned working in the ER. I don’t plan on going into this field, but the skills I learned will be helpful in the ER settings I hope to find myself in. 3 credits here.

Diagnostics and Clinical Procedures I – Another class I really enjoyed and found fairly easy, in part because of my ED experience. There’s a few times I’d have to remind myself that what I learned in the ED was not always the same as what the class expected. But it’s a good class. I look forward to the next part in the spring. One area that I did particularly well in was EKGs. Again, experience in the ED, plus some of my own self-education, as well as RPI math and physics helped. Only 3 credits, but sort of countered my Pharm grade. I have one last test to go. This should be the hardest of the tests in this class.

Evidence Based Practice – This class a mixed bag. I referred to it as our version of the “Defense against the Dark Arts”. It is in my mind, actually one of the more important classes we’re taking. A lot of it is focused on why and how we do certain things, i.e. what’s the evidence for certain practices. It’s not something that can be taught “in the field.” (which honestly, a lot of the above classes can be to an extent.) There’s important stuff in this class. For example, we examined the original “Wakefield” paper that sort of started the “Autism is caused by vaccines” movement (hint the paper is terrible on several standards and actually doesn’t come out and say that.) I knew I was old when none of my classmates recognized the name of former Dr. Wakefield. But the structure of the class left many of us a bit frustrated. This was apparently true last year and they had restructured it for this year. My understanding was even two years ago had issues (hence my DaDA comment above). I’m doing great in the class, so it’s not a matter of sour grapes. But I do hope they find an even better way to teach this class to future cohorts. Only 2 credits because of the amount of work, but an important 2 credits I think.

Professional Practice II – another important class. This is about how to be a PA. This is the other class the same paper is due in. I’m doing great in it, but being only 1 credit, doesn’t influence my overall GPA at all.

So that’s my semester in the books. What’s Spring look like?

• Medicine II – 6 credits this time – more of the above
• Physical Diagnosis II – 3 credits this time – more of the above
• Pharmacology and Therapeutics III – 3 credits – Hope to do better this time
• Clinical Decision Making in Primary Care – 3 credits – This will be less multiple choice and more written answers so should be interesting
• Diagnostics and Clinical Procedures II Certification – 3 credits – One detail here, is I get ACLS certified. Which means in theory I can run a cardiac code. In practice I can’t because I don’t have my PA certification
• Emergency Medicine – 3 credits – Ironically, because of my experience, I expect this to be a difficult class. Not because of the material but because I’ll definitely have to separate what I learned and saw from what they are testing us on.
• Surgery – 3 credits – I look forward to this. As a PA I can’t do surgery without supervision, but I will be able to assist and I will be able to do things like sutures, etc. So this should be fun.
• Professional Practice III – 1 credit – more of the same.

If you do the math, you’ll see it’s another 25 credits. Then on to clinical rotations which I’ll write more about in the future.